摘要
众所周知,心血管疾病是2型糖尿病患者发病和死亡的主要原因。在过去的几年里,讨论最多的话题之一是抗糖尿病药物的CV安全性。关于老年抗糖尿病药物的CV安全性,数据不太清楚,关于其CV安全性的结论主要是基于旨在评估其降糖效果的随机对照试验。在这篇综述中,我们总结了当前有关旧的和新的抗糖尿病药物的CV安全性的知识。根据已发表的文献,二甲双胍是治疗2型糖尿病的第一种药物,似乎具有心脏保护作用。当二甲双胍单药不能达到HbA1c靶点时,第二线药物的选择就不那么清楚了。根据EMPA-Reg结果试验的发现和最近发表的6项试验的领导者和持续6项试验,表观利氟嗪、利拉格鲁帝和半谷胱甘肽作为CV病患者的二线药物似乎是合理的选择。另一方面,磺脲类药物,除格列齐特外,应在这些患者中加以避免,尽管目前尚缺乏CV安全性试验。在没有CV疾病的个体中,任何其他类型的抗糖尿病药物都可以通过以病人为中心的方法来选择。Saxagliptin、alogliptin、sitagliptin和Lixisenatide已在CV安全性试验中得到评价,并对CV结果产生中性影响,而吡格列酮可能具有一定的CV效果。然而,在心力衰竭患者中应避免使用沙司他汀和阿霉素,而吡格列酮在这一人群中是违禁的。
关键词: 心血管事件,二甲双胍,磺脲,吡格列酮,胰岛素,二肽酰肽酶-4抑制剂,胰高血糖素样肽-1受体激动剂,钠-葡萄糖共转运蛋白-2抑制剂。
Current Medicinal Chemistry
Title:Update on Cardiovascular Effects of Older and Newer Anti-diabetic Medications
Volume: 25 Issue: 13
关键词: 心血管事件,二甲双胍,磺脲,吡格列酮,胰岛素,二肽酰肽酶-4抑制剂,胰高血糖素样肽-1受体激动剂,钠-葡萄糖共转运蛋白-2抑制剂。
摘要: It is known that Cardiovascular (CV) disease is the leading cause of morbidity and mortality in individuals with type 2 diabetes. Over the last years, one of the most discussed topics is the CV safety of anti-diabetic medications. Regarding CV safety of older antidiabetic agents the data are less clear and conclusions about their CV safety are mostly based on randomized controlled trials designed to assess their glucose lowering efficacy. In this review, we summarize the current knowledge about the CV safety of older and newer antidiabetic medications.
According to the published literature metformin is the first line agent for the treatment of type 2 diabetes and seems to have cardio-protective effects. The choice of the second line agent when metformin monotherapy fails to achieve HbA1c targets is less clear. In the light of the findings of the EMPA-REG OUTCOME trial and the recently published LEADER and SUSTAIN 6 trials, empagliflozin, liraglutide and semaglutide seem reasonable options as second line agents for patients with CV disease. Sulfonylureas on the other hand, with the exception of gliclazide, should be avoided in those patients, although CV safety trials are still lacking. In individuals without CV disease any of the other classes of anti-diabetic medication can be selected on a patient-centered approach. Saxagliptin, alogliptin, sitagliptin and lixisenatide have been evaluated in CV safety trials and have neutral effects on CV outcomes, while pioglitazone may have some CV benefits. Saxagliptin and alogliptin, however, should be avoided in patients with heart failure, while pioglitazone is contraindicated in this population.
Export Options
About this article
Cite this article as:
Update on Cardiovascular Effects of Older and Newer Anti-diabetic Medications, Current Medicinal Chemistry 2018; 25 (13) . https://dx.doi.org/10.2174/0929867324666170530075533
DOI https://dx.doi.org/10.2174/0929867324666170530075533 |
Print ISSN 0929-8673 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-533X |
Call for Papers in Thematic Issues
Advances in Medicinal Chemistry: From Cancer to Chronic Diseases.
The broad spectrum of the issue will provide a comprehensive overview of emerging trends, novel therapeutic interventions, and translational insights that impact modern medicine. The primary focus will be diseases of global concern, including cancer, chronic pain, metabolic disorders, and autoimmune conditions, providing a broad overview of the advancements in ...read more
Approaches to the treatment of chronic inflammation
Chronic inflammation is a hallmark of numerous diseases, significantly impacting global health. Although chronic inflammation is a hot topic, not much has been written about approaches to its treatment. This thematic issue aims to showcase the latest advancements in chronic inflammation treatment and foster discussion on future directions in this ...read more
Cellular and Molecular Mechanisms of Non-Infectious Inflammatory Diseases: Focus on Clinical Implications
The Special Issue covers the results of the studies on cellular and molecular mechanisms of non-infectious inflammatory diseases, in particular, autoimmune rheumatic diseases, atherosclerotic cardiovascular disease and other age-related disorders such as type II diabetes, cancer, neurodegenerative disorders, etc. Review and research articles as well as methodology papers that summarize ...read more
Chalcogen-modified nucleic acid analogues
Chalcogen-modified nucleosides, nucleotides and oligonucleotides have been of great interest to scientific research for many years. The replacement of oxygen in the nucleobase, sugar or phosphate backbone by chalcogen atoms (sulfur, selenium, tellurium) gives these biomolecules unique properties resulting from their altered physical and chemical properties. The continuing interest in ...read more
![](/images/wayfinder.jpg)
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
cAMP-Mediated Regulation of CYP Enzymes and Its Application in Chemotherapy
Drug Metabolism Letters Effects of Metabolic Approach in Diabetic Patients with Coronary Artery Disease
Current Pharmaceutical Design Osteoprotegerin and Diabetes-Associated Pathologies
Current Molecular Medicine New Analogues of Mycophenolic Acid
Mini-Reviews in Medicinal Chemistry Arginine Deprivation as a Targeted Therapy for Cancer
Current Pharmaceutical Design Biofilms: An Extra Hurdle for Effective Antimicrobial Therapy
Current Pharmaceutical Design Device-based Therapies for Resistant Hypertension
Current Pharmaceutical Design Current Biology of MTP: Implications for Selective Inhibition
Current Topics in Medicinal Chemistry Innovations in siRNA Research: A Technology Comes of Age
Recent Patents on Anti-Infective Drug Discovery Overview of Pediatric Epilepsy
Current Pediatric Reviews Hematopoietic Progenitor and Stem Cells Circulate by Surfing on Intracellular Ca2+ Waves: A Novel Target for Cell-based Therapy and Anti-cancer Treatment?
Current Signal Transduction Therapy Role of Renin-Angiotensin-Aldosterone System in Metabolic Syndrome and Obesity-related Hypertension
Current Hypertension Reviews Molecular Predictors of Drug-induced Prolongation of the QT Interval
Current Medicinal Chemistry - Cardiovascular & Hematological Agents Incidence and Prevalence of Hypothyroidism in Patients Affected by Chronic Heart Failure: Role of Amiodarone
Endocrine, Metabolic & Immune Disorders - Drug Targets Long Noncoding RNA OIP5-AS1 Overexpression Promotes Viability and Inhibits High Glucose-Induced Oxidative Stress of Cardiomyocytes by Targeting MicroRNA-34a/SIRT1 Axis in Diabetic Cardiomyopathy
Endocrine, Metabolic & Immune Disorders - Drug Targets Actions of Rho-Kinase Inhibitors in Cardiovascular Diseases
Current Enzyme Inhibition Arterial Stiffness and Cardiovascular Drugs
Current Pharmaceutical Design Inhibition of Receptor Tyrosine Kinases in Combination with Chemotherapy for the Treatment of Breast Cancer
Anti-Cancer Agents in Medicinal Chemistry Endothelial Progenitor Cells in Prehypertension
Current Pharmaceutical Design Phage Display as a Tool for Protease Ligand Discovery
Current Pharmaceutical Biotechnology